A Randomized Controlled Trial of Clinical Hypnosis as an Opioid-Sparing Adjunct Treatment for Pain Relief in Adults Undergoing Major Oncologic Surgery

Abstract

Brittany N Rosenbloom,1– 3 P Maxwell Slepian,1,2,4 Muhammed Abid Azam,1,2 Andrea Aternali,1 Kathryn A Birnie,5,6 Kathryn Curtis,2 Sonal Thaker,2 Salima Ladak,2 Anna Waisman,1 Hance Clarke,2,4 Joel Katz,1,2,4 Aliza Z Weinrib1,2 1Department of Psychology, York University, Toronto, ON, Canada; 2Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada; 3Toronto Academic Pain Medicine Institute, Women’s College Hospital, Toronto, ON, Canada; 4Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; 5Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, AB, Canada; 6Department of Community Health Sciences, University of Calgary, Calgary, AB, CanadaCorrespondence: Joel Katz; Aliza Z Weinrib, Department of Psychology, York University, BSB 232, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada, Email [email protected]; [email protected]: Clinical hypnosis is an effective strategy for managing acute pain in the surgical setting. However, the opioid sparing effects of clinical hypnosis are not as well understood. This pre-registered (NCT03730350) randomized, controlled trial (RCT) examined the impact of clinical hypnosis, pre- and post-surgery, on opioid consumption during hospitalization as well as on measures of pain intensity, pain interference, depressed mood, anxiety, sleep, and pain catastrophizing. Participants (M = 57.6 years; SD = 10.9) awaiting oncologic surgery were randomized to treatment-as-usual (n = 47) or hypnosis (n = 45). Intent-to-treat analyses were conducted using linear mixed effects modeling. A significant Group × Time interaction, F(6, 323.34) = 3.32, p = 0.003, indicated an opioid sparing effect of clinical hypnosis during the acute postoperative period. Hypnosis also protected against increases in pain catastrophizing at one-week after surgery, F (1, 75.26) = 4.04, p = 0.048. A perioperative clinical hypnosis intervention had a sparing effect on opioid consumption in-hospital after major oncologic surgery. These findings extend the efficacy of clinical hypnosis as an adjunct tool for perioperative pain management.Keywords: clinical hypnosis, oncologic surgery, postoperative opioid use, postoperative pain, pain catastrophizing

Keywords

• clinical hypnosis
• oncologic surgery
• postoperative opioid use
• postoperative pain
• pain catastrophizing